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Rotigaptide is a synthetic hexapeptide drug developed as an antiarrhythmic agent, primarily investigated for the treatment of cardiac arrhythmias such as atrial fibrillation. Its mechanism of action involves increasing gap junction intercellular conductance in cardiac muscle cells by modulating connexin 43 (Cx43), thereby promoting electrical coupling between myocytes and stabilizing cardiac rhythm. Rotigaptide does not act on ion channels but specifically augments gap junction communication, which is a novel approach for managing arrhythmias. The drug was originally developed by Zealand Pharma and later licensed to Wyeth Pharmaceuticals for further clinical development[1][5][6][7].
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